November 5, 1927


JAMA. 1927;89(19):1621. doi:10.1001/jama.1927.02690190059023

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Treatment of Bone Tuberculosis  In previous letters reference has been made to the operation suggested by Dr. Robertson Lavalle—recently appointed professor of pathologic surgery in the Buenos Aires medical school—for the treatment of tuberculosis of the bones. The operation consists in trephining obliquely from the shaft to the end of the bone. Through the opening a bone nail is inserted as a sort of graft. The subject was recently discussed at length before the Buenos Aires Surgical Society. Ruiz Moreno, Rivarola, Del Valle and Tamini cited failures. Robertson Lavalle replied that his method is not dangerous; he has had only four cases of meningitis among 400 patients operated on. Trephining must reach the tuberculous focus. A "circulatory strangulation" exists there; thence the black appearance of the blood discharged. One must, however, aim at having the penetration end at the congestive area and not the purulent focus itself. Healing, according to

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